29-494 ' •,.
The Commonwealth of Massachusetts
Department of Industrial ACcidents
=.......17,..■ /
Office of •
• =.-- 1— .....
600 Washington Street
il -
t i. 4..-71 z r •
..„,,, ...7,..trar ..,. Boston, MA 02111
--=',..0, www.mass.gov/dia
. •
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly --'•
,---,
Name (Businesi/Organization/IndivirinnD: .._c.-.:,(/-4,./ ,/ ,./5,4-, 6 ce /c_bc . 21 ;7
,.. -
Address:
City/State/Zip: /777- e-7 o / 6 / W Phone.#: y / 3 )_ /5; 3
i"
Are you an employer? Check the appropriate box: • Type of project (required): 1
1.X. I am a employer with / 4. D I am a general contractor and I
6. 0 New construction
have hired the sub-contractors
employees (full and/or part-time).*
listed on theattached sheet. 7. 0 Remodeling
2.0 I am a sole proprietor or partner-
These sub-contractors have. . • shin .id have no. employees 8 . 0 Demolon
working for me in any rapacity enaployees and laa.ye workers 9 .... • .. . •
: O B
[No workers' comp insurance _ corrp...instrraTice. ;_ _ _.____ •.... ..,. __ .
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3. 0 I am a horaeowner doing all work officers ha their 11.0 Plunabing repair s or additions
1.
myself [No workers' conap. right Of exeraption per MGL
12.0 Roof repairs
insurance requiTeci] t • p. 152, § 1(4), and we have no •
erup
comp loy [No msuranc. e 1 13,-1 Other
. -
*Any applicant-that checks box #1 must aLso fill out the section below showing their - workers' compensation policy information.
t Homeowneri who subrnit this affida indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not-those entities have
employees If the sub-contractors Italie employees, they must provide their workers' comp policy number.
J am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information. ----.,
Insurance Company Name4S
Policy # or Self-ins. Lic. #: 5 - 6 e )646 Vc (2 e ,e tc Expiration Date: - 5 3 // ,
. (--
Job ite Address: " (f /q r i:/ A c . City/State/Zip:' ,/),'
Attach a copy of the workers' compensation policy declaration page (showing the policy munber and expiration date).
Failure to secure coverage as required under Seetiiiii'25KOfMGL'c. 152 can lead to the inipOsitiOn Of criMinil Penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK-ORDIM and a fine
of up to $250.00 a day against the violatar. Be advised that a copy of this statement may be forwarded to the Officeof,,
IfiV the DLk for insurance 6iiiie - - ....
I do hereby ,certibt under the painsand penalties ofpetjury that the information providid:ahavais_trueitndiorrect.L_____
Si • C__, , 4_
01 • 1 • nue: I 4
,-;•-.....-- -....._-, • •
----
Phone it: y ( 3 - •' 7 , 4-- 3 / '9 & . - ' - •
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: .- • Permit/License # '
---- - - -
Issuing Authority (circle one):
. 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Iaspector 5. Plumbing Inspector
6. Other , 6- . - .
Contact Person: Phone #:
SECTION 8 -- CONSTRUCTION SERVICES
8.1 Licensed Construction - S Not Applicable ❑
Name of License Holder : �/ G' /?'- / / -21&" --ed ` r/ > d .e y
License Number
g 42- G c> 0 2,- Ec 41i/f. /7 4f°ic -zo At ..1— 21 a sjz
Address Expiration Date
N
t f -"--' y J r 3 2 0
Signature i Telephone
9:: Registered Home. Improvement Contractor: a . .:.. .,` , . „ a .• _Y.a, x,, , ,L f. , v. , s;.a Not Applicable ❑
/GE(..) /33
Company Name Registration Number
J "/3' f,l 2/4-2.7,,-1,11( r_c < -) � C,/y( z
Address Expiration a te
V/3 2, 1 r j/ o
67 Gam ,32, /,.+w. , c t- C/2 /%77/ t a 1 Telephone
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M. G. L, c. 152, §I25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes fQ No ❑
11 Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellines of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House [l Addition ❑ Replacement Windows Alteration(s) ❑ Roofing E] Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [C] Siding MI Other [0]
Brief Description of Proposed 49"741.1. �' `` '/c' 44) . ' "���xt+s , �, s�r✓zL 5 Di --
Work: /VArd --r Si 4' / ,acc,}C
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
Oa if New house and or addition to'existing housing; complete the following:
a. Use of building : One Family / Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms /
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain _ Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I , / el /e , as Owner of the subject
property
hereby authorize !h✓ %� �C"'�� - 's/`1.
to act on behalf, in -II matters relative to work authorized by this building permit application.
Signatur: of Owner Date
I � 2 / i/ ° /�-'" �` "' j�`� as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print N. e
Signature .f • ner /Agent Date
• v Dep use anly
• Ci , of Northampton Status of Pfrrnm :
Bu ding Department CurbGt tlDr`lyewa I�e r rnft - ~;3 ,��t
JUL — 6 2011 12 Main Street g „; t,
Sewer ,1S A#Sbilitlr ,' ,
Room 100 ater/ ll ility ° k i sfl a � s l a c � �
OF BUILDING wsPecTio • : mpton, MA 01060 fwa $ ofStr dut�a Pl �` �` ��
� � 413- 587 -1240 Fax 413 - 587 -1272 ot/ ite Plans ` ia * , g n t 3 �
QQthel Spe ol ,. .,.. . _ r.: �:,Y , ,
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address:
This section to be completed by office
s ” /ti. if1z.: /7rr„fD >Map Lot -Un
4/ /
�Z y/2 c- i•;7- , 1 Zon Overlay District
Elm St District CB District
SECTION 2- PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 / O , w , ner of Recoord
Name (Print) Current Mailing Address:
f Telephone
Signature
____,----
2.2 Author Agent: 1�
/ j2e 2) " 04
�' 4 ,,,,,,,..., // , . —ICI —t/ ..rj/41 (mac' >�+t� � /�[, /`K �'
Name (Pent) Current Mailing Address:
n
�= 1, 4') i ?/ e1
Signat Telephone
SECTIO - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Use Only
completed by permit _applicant
1. Building �, (a) Building Permit Fee
/ j trecs
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection 0/
6. Total= (1 +2 +3 +4 +5) /3. t'c . cu Check Number � t Q /
This Section For Official Use Only
Date
Building Permit Number: issued:
Signature:
Building Commissioner /Inspector of Buildings Date
415 RYAN RD BP- 2012 -0012
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29 - 494 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: replacement windows /siding BUILDING PERMIT
Permit # BP- 2012 -0012
Project # JS- 2012- 000020
Est. Cost: $13000.00
Fee: $78.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN ZIEMINSKI 017889
Lot Size(sq. ft.): 20168.28 Owner: RYAN KEVIN J & LORRAINE A
Zoning: URA(100) //WSP Applicant: JOHN ZIEMINSKI
AT: 415 RYAN RD
Applicant Address: Phone: Insurance:
8 WOODRIDGE CIRC (413) 247 -9014 Workers
Compensation
HATFIELDMA01038 ISSUED ON:7/6/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE SIDING,WINDOWS & DOOR
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House # Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 7/6/2011 0:00:00 $78.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner
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Aug 02 11 03:03p Ov. neripeal 413 -684 -2021 p.1
Short Form .Job: RYAN t Date:
r Entire House By DAVE ON
_
le If _ ALL SEASONS HEATING &AC
31 SCtt•:GLE -- EET,HATf-"E G.Gf,u nP -,on:_A' 2 -24J -:932 Fax 413-247-9E42
- Pro et1nformatior>r
For RYAN
D esign tnfortnation
Htg CIg Infiltration
Outside db ?`'F) 0 87 Method Simplified
Inside db (°F) 70 75 Construction quality Average
Design TD (F) 70 12 Fireplaces 0
Daily range - M
Inside humidity ( %) 50
Moisture difference 'grtIbi - 24
HEATiNG EQUIPMENT COOLING EQUIPMENT
Make Make
Trade Trade
Model Gond
Coil
Efficiency 80 AFUE Efficiency 0 EER
Heating input 0 Stun Sensible cooling 0 Btuh
Heating output 0 Btuh Latent cooling 0 Btuh
Temperature rise 0 `F Total cooling 0 Btuh
Actin air flow 581 cfm Actual air flow 581 cfm
Air flow factor 0.024 cfm /Btuh Air flow factor 0.053 cfm/Btuh
Static pressure 0.00 in H2O Static pressure 0.00 in H2O
Space thermostat Load sensible heat ratio 0.91
r
ROOM NAME — Htg load Clg load HtgAVF CIgAVF
(ft2) (Btuh) (Btuh) (cfm) (cfm)
KITCHEN 252 5243 2256 126 121
LIVING 252 1 6891 i 3471 166 : 186
HALL 33 213 63 5 3
BATH 72 1494 688 36 37
OFFICE 80 2503 ! 1238 60 66
BED 154 ii 4755 1 2415 1 115 i 129
BED 2 140 I 3032 738 73 j 39
Entire House d . 983 1 24132 10869 581 531
Other equip loads 0 9990
Equip. @ 0.92 RSM
Latent cooling
j 1058
TOTALS — --� 983 24132 11057 581 581
Printout ce tIhec by ACCA to meet all requirements of Manual 3 7th Ed.
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t"1f��"3'�SCI°� k• gat- 3.s'e4ascie,paF5�So`FiSR43'12 2011- A�3-02i5:53:19
ACC:i C.'Sh^:ed`!d r Dc i nw'ts1. iricitci h'- aC'A.LL SErSO`4S R':',NJTa Cec =ti,,; Oiientaion = N Page -
INSURANCE COVERAGE: N
have a current liability policy equivalent olic or its a uivalent which meets the requirements of M.G.L. Ch. 112 Yes CJ No ❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy El Other type of indemnity El Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee dnem not have the insurance coverage required by Chapter 112 of the
Massachusetts General La , nd that my si�. re on this permit application Waixesthis requirement.
Check One Only
//1/407 Owner ❑ Agent ❑
Signature of Owner or ers t
By checking this bo zo, I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation: YES NO
Prngrves incrPcfions
Date Comments
Final InerPrtion
Date Comments
Type of License:
By Master (I(
Title ❑ Master - Restricted
City/Town ❑Jou rneyperson
Si • .tune - Licensee
Permit #
❑Journeyperson- Restricted 0
License Number: I.
Fee $ ❑
Check at
L!
ns ector Signature of Permit Approval
P 9 APP
.nm. /'— 1.,:-
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X2012
` MP 2 Commonwealth of Massachusetts
1
L 0 ,- 6 ,, r„l tis o, ° "S City Of Northampton
Date: `a -I - 7- a t>1'1.. Sheet Metal Permit Permit # 5 M ) a 51(
Estimated Job Cost: $ \\ 0OC _ ®-p Permit Fee: $ 6 ,0 L)
Plans Submitted: YE NO Plans Reviewed: YES NO
Business License # 1a" j Applicant License # \19
Business Information: Property Owner / Job Location Information:
Name: ..t -i9t?_ @\9Pv5')Name: V*Ve-\1 \1') R
Street: 93 E Street: 'AI 5 R c1..) `'1 oi1
City /Town: \A * 1C` 4 j 'AA City/Town: nOceA c , \P
Telephone: `sa N ?- C r C is 9a Telephone: 5(Y? - 1 C i 1 9
Photo I.D. required / Copy of Photo I.D. attached: YES NO
Staff Initial
J -1 / estricted license
J -2 / M- 2- restricted to dwellings 3- stories or less and commercial up to 10,000 sq. ft. / 2- stories or less
Residential: 1 -2 famii 4 Multi - family Condo / Townhouses Other
Commercial: Office Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq� ®j over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work Renovation:
HVAC Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney / Vents Air Balancing
Provide detailed description of work to be done:
71.V) 'A.44k\t". A.19 .t Oc )02 k_t, 1 1 C -1 ( b_D( A. Gek
Fees with Building Permit: $25.00 Residential, $50.00 Commercial. Fees for jobs without a Building Permit $6.00 per $1000
Minimum fees for jobs without Building Permit $50.00 Residential, $100.00 Commercial
File # SM- 2012 -0034
APPLICANT /CONTACT PERSON ALL SEASONS HEATING AIR
ADDRESS /PHONE 93 ELM ST (413) 247 -9842
PROPERTY LOCATION 415 RYAN RD
MAP 29 PARCEL 494 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 7/ 5
Fee Paid / Y �"
Typeof Construction: INSTALL NEW A/C DUCT SYS
New Construction Q d
Non Structural interior renovations Addition to Existing ?
�' L`
Accessory Structure (
Building Plans Included:
PLI Owner/ Statement or License 129
3 sets 4f Plans / Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
RMATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER : §
Intermediate Project : Site Plan AND /OR Special Peii,ut with Site Plan
Major Project: Site Plan AND /OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
P 't frpn E '. Street Commission Permit DPW Storm Water Management
S
Signa e of Building Of icial Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning & Development for more information.
415 RYAN RD SM- 2012 -0034
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS #: 5204
Map. 29 ��,�`,
Block: 494�,
Lot: - � SHEETMETAL. PERMIT
Permit: SHEETMETAL E�/
Category: SHEETMETAL
Permit # SM- 2012 -0034 PERMISSION IS HEREBY GRANTED TO:
Project # JS -2012- 001765
Est. Cost: $11,000.00 Contractor: License: Expires:
Fee Charged: $50.00 ALL SEASONS HEATING AIR Sheetmetal - 129
Balance Due: $.00 Owner: RYAN KEVIN J & LORRAINE A
# of Fixtures: Applicant: ALL SEASONS HEATING AIR
DigSafe # AT: 415 RYAN RD
UseGroup
ConstClass
ISSUED ON: 22- May -2012 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
INSTALL NEW A/C DUCT SYS - DUCT BLAST REQUIRED
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fixtures:
Floor: Type: # of Fixtures Floor: Type: # of Fixtures
Fee Type: Receipt No: Date Paid: Check No: Amount:
Sheetmetal REC -2012- 006304 21- May -12 3761 $50.00
212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :lhasbrouck @northamptonma.gov
GeoTMS® 2012 Des Lauriers Municipal Solutions, Inc.
9 -rive
kr :C
30 West Pomeroy Lane
Amherst, MA 01002 2 4
2012
AH V h' ... Phone: 413- 835 -5162 DEPT. OF BUILDING INSPECTIONS
Email: matt.turcotte @gmail.com NORTHAMPTON MA 01060
POWERHOUSE
Site Information
Date Of Test: 5/23/2012
Client: All Season Heating & Air Conditioning
Site Address: R an Rd
Northampton, MA 01060
Test Performed By: Matt Turcotte
Job #: 12 -012 -d
Duct Pressurization Test Results
Type of Test Performed: Post- Construction, leakage to outside (8%)
Duct System 1
Conditioned Floor Area: 1092 sq ft
Duct Flow at 25 Pa: 60 GEM
Duct Leakage: 5.49 CFM per 100 sq ft of conditioned floor area
TEST RESULT : PASS
Duct System 2 (if applicable)
Conditioned Floor Area: N/A sq ft
Duct Flow at 25 Pa: N/A GEM
Duct Leakage: N/A CFM per 100 sq ft of conditioned floor area
TEST RESULT: N/A
Notes on Area Tested and /or Testing Conditions:
Do no remove until final inspection. Please retain for future reference,
)0 qualified for area indicated. '
Admissible pour les regions indiquees,
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Nato al Fenestration Vinyl•Clad Wood Prase, Dual•Pane loi -E Glazing
Re lg Councile with Argon
Q - TIMED Product Type: Vertical Sliders
ENERGY PERFORMANCE RATINGS
U.Factor Solar Heat Gain Coefficiet t
0.291.65 0.31
1,S. /I•P) (Metric/$1)
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
0.54
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Menem, er stipulates /nit these ratings conform to applicable NFAC procedures for determining mole product
performal e. NFBC ratings are determined for a fixed set of environmental conditions and a specific croduct s1ie
NM doe not recommend any product and does not .arrant toe suitability of soy product for any Specific use
Consult , nufaeturer's literature for otner product performance information .
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WINDOW AND DOOR
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CCL# 129-H-841
Andersen Corporation: 400 Series Tilt Wash Window
Manufacturer stipulates conformance to the applicable standards,
STANDARD Rating _
AWAJW)AJCSA 10111S2JA440 - Class LC -P630 Size Tested 45" x 77"
DP +30j - 30 —_-
ANA /WCMA /CSA 101/IS2/A440.05 H -LC30 size Tested 45" x 77"
0P+30/ 90
FL 1091
Glazing: 2.2mm AN outer/2.3mm HS inner
M 044 rMa product moats crem Complie wi th HUD UM Bulletin No, 111
,,,,y, Sears environmental
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w energy efficiency, heavy
a. meted, in the frame and
4 b sash materials, packaging,
t ERIN' and consume education
150112104PKU -1
Neets o eY,ceeds MEC., CEC, & IEC C Air Infiltration Requirements #DHW Hallnar5 Certification Fin ( -um
415 RYAN RD BP- 2012 -0012
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29 - 494 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: replacement windows /siding BUILDING PERMIT
Permit # BP- 2012 -0012
Project # JS- 2012- 000020
Est. Cost: $13000.00
Fee: $78.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN ZIEMINSKI 017889
Lot Size(sq. ft.): 20168.28 Owner: RYAN KEVIN J & LORRAINE A
Zoning: iiR A(1001.i/WSP Applicant: JOHN ZIEMINSKI
AT: 415 RYAN Rid
Applicant Address: Phone: Insurance:
8 WOODRIDGE CIRC (413) 247 -9014 Workers
Compensation
HATFIELDMA01038 ISSUED ON :7/6/2011 0 :00 :00
TO PERFORM THE FOLLOWING WORK :REPLACE SIDING,WINDOWS & DOOR
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House # Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Qii: Insulation:
Final: Smoke: Final: F 1 O ,k C/V -
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND RE .. • 0�
7 6444;0 /A et t
Certificate of Occupancy s , nature:
FeeType: Date Paid: Amount:
Building 7/6/2011 0:00:00 $78.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Conunissioner